代谢综合征中医证型与颈动脉内-中膜厚度及血浆脂蛋白磷脂酶A2的关系研究

Relationship between tradition Chinese medicine syndrome types of metabolic syndrome and carotid intima-media thickness and lipoprotein phospholipase A2

目的探究代谢综合征(MS)常见中医证型与颈动脉内-中膜厚度(IMT)及血浆脂蛋白磷脂酶A2(Lp-PLA2)的关系,为MS中医辨证论治提供客观依据。方法选取MS患者60例作为研究组,经中医辨证分为气滞湿阻型、痰瘀互结型、气阴两虚型、脾肾气虚型4种证型,同时纳入健康体检者30人作为健康对照组,比较2组及研究组各型患者颈动脉IMT、血浆Lp-PLA2水平。结果研究组颈动脉IMT、血浆Lp-PLA2水平高于对照组(P<0.05)。研究组4种证型颈动脉IMT、血浆Lp-PLA2水平依次为:痰瘀互结型>气阴两虚型>脾肾气虚型>气滞湿阻型。痰瘀互结型、气阴两虚型颈动脉IMT高于脾肾气虚型、气滞湿阻型(P<0.05)。气阴两虚型、脾肾气虚型、气滞湿阻型血浆Lp-PLA2水平均低于痰瘀互结型(P<0.05);脾肾气虚型、气滞湿阻型血浆Lp-PLA2水平均低于气阴两虚型(P<0.05)。结论MS患者痰瘀互结型颈动脉IMT和血浆Lp-PLA2水平较高,颈动脉IMT、血浆LP-PLA2可以作为MS患者中医辨证分型的参考。

Objective To explore the relationship between common tradition Chinese medicine(TCM)syndrome types of metabolic syndrome(MS),and carotid intima-media thickness(IMT),and lipoprotein phospholipase A2(Lp-PLA2),so as to provide an objective basis for syndrome differentiation and treatment of MS.Methods Sixty MS patients were selected as the research group,they were divided into four types according to TCM syndrome differentiation:qi stagnation and dampness resistance type,phlegm and blood stasis type,qi and yin deficiency type,spleen and kidney qi deficiency type.At the same time,30 healthy subjects were included as the control group,and the carotid IMT and Lp-PLA2 levels in the two groups were compared.Results The levels of IMT and plasma Lp-PLA2 in the study group were higher than those in the control group(P<0.05).The carotid IMT and plasma Lp-PLA2 levels in the four syndromes were as follows form high to low:phlegm and blood stasis type>qi and yin deficiency type>spleen and kidney qi deficiency type>qi stagnation and dampness resistance type.Carotid IMT in phlegm and blood stasis type and qi and yin deficiency type was higher than that in spleen and kidney qi and in deficiency type and qi stagnation and dampness resistance type(P<0.05).Lp-PLA2 levels in qi and yin deficiency type,spleen and kidney qi deficiency type and qi stagnation and dampness resistance type were lower than those of phlegm and blood stasis type(P<0.05).The levels of Lp-PLA2 in spleen and kidney qi deficiency type and qi stagnation and dampness resistance type were lower than those in qi and yin deficiency type(P<0.05).Conclusion The levels of IMT and Lp-PLA2 were higher in MS patients with phlegm and blood stasis syndrome.IMT and Lp-PLA2 can be used as a reference for TCM syndrome type differentiation of MS patients.